Main Article Content
Introduction: ERM is a cellular proliferation on the inner retinal surface and possesses contractile properties which leads to variable visual symptoms.
Method: Thirty-four patients affected with epiretinal membrane were enrolled in this study. All patients underwent standard three port pars plana vitrectomy using standard 23-gauge instruments. Both ERM and ILM peels were performed in a circumferential pattern around the fovea. Patients were followed for 6 months. The visual outcome measures included postoperative logMAR visual acuity. The anatomical outcome was measured as decrease in foveal thickness on spectral domain optical coherence tomography (SD-OCT). Perioperative factors including duration of symptoms, preoperative visual acuity, etiology, membrane type and leakage on fundus fluorescein angiogram were correlated with the final visual outcomes.
Results: The mean age of the patients in this study was 60.25 17.5 years with a range of 16 to 80 years. 19 patients (56%) were males. 33 patients had a unilateral ERM and 1 patient had an ERM in both eyes. Diminution of vision was the most common symptom in 34 patients, distortion of vision (metamorphopsia) was seen in 20 (58.8%) patients. The mean pre-operative log MAR best corrected visual acuity (BCVA) was 1.4±0.77 and the mean post-operative log MAR best corrected visual acuity (BCVA) was 0.9 ±0.63. Out of 34 patients in our study, 31 (91.2%) had improvement in VA, and the remaining 3 (8.82%) patients had no improvement and none of the patients had decreased vision. 16 patients had ≥2 lines of improvement in visual acuity. 15 patients had less than 2 lines of improvement.
Conclusion: ERMs pose a significant risk to compromise the vision and affect varied age groups. ERM removal through standard three port pars plana vitrectomy offers an effective and safe procedure with better post operative visual outcomes.
ERM, OCT, LOG MAR, VITRECTOMY, VISUAL ACUITY
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
(2)Iwanoff A.Beiträge zur normalen und pathologischen Anatomie des Auges. Graefes Arch Clin Exp Ophthalmol.1865;11:135-70.
(3) Sidd RJ, Fine SL, Owens SL, Patz A. Idiopathic preretinal gliosis. Am J Ophthalmol.1982;94:44-8.
(4) McLeod D, Hiscott PS, Grierson I. Age related cellular proliferation at the vitreoretinal juncture. Eye 1987;1:263-81.
(5). Sandali O, El Sanharawi M, Basli E, Bonnel S, Lecuen N, Barale PO, Borderie V, Laroche L, Monin C. Epiretinal membrane recurrence: incidence, characteristics, evolution, and preventive and risk factors. Retina. 2013;33(10):2032-8.
6) Wong JG, Sachdev N, Beaumont PE, Chang AA. Visual outcomes following vitrectomy and peeling of epiretinal membrane. Clin Exp Ophthalmol. 2005;33(4):373-8.
7) Rice TA, De Bustros S, Michels RG, Thompson JT, Debanne SM, Rowland DY. Prognostic factors in vitrectomy for epiretinal membranes of the macula. Ophthalmology. 1986; 93(5):602-10.
8) Shahzadi B, Rizvi SF, Latif K, Murtaza F, Naz S. Visual and Anatomical Outcomes Following Idiopathic Macular Epiretinal Membrane Surgery. J Coll Physicians Surg Pak. 2016; 26(12): 971-974.
9) Mitchell P, Smith W, Chey T, Wang JJ, Chang A. Prevalence and associations of epi‐retinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology1997;104: 1033-40.
10) Michels RG, Wilkinson CP, Rice TA. Retinal detachment. St Louis: CV Mosby; 1990:1096-8.
11) Kaiser PK. Prospective evaluation of visual acuity assessment: a comparison of snellen versus ETDRS charts in clinical practice (An AOS Thesis). Trans Am Ophthalmol Soc. 2009;107:311-24
12) Michels RG. A clinical and histopathologic study of epiretinal membranes affecting the macula and removed by vitreous surgery. Trans Am Ophthalmol Soc. 1982;80:580-656
13) Kwok AKh, Lai TY, Yuen KS. Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Exp Ophthalmol. 2005;33(4):379-85.
14) Wong JG, Sachdev N, Beaumont PE, Chang AA. Visual outcomes following vitrectomy and peeling of epiretinal membrane. Clin Exp Ophthalmol. 2005;33(4):373-8.
15) Pournaras CJ, Emarah A, Petropoulos IK. Idiopathic macular epiretinal membrane surgery and ILM peeling: anatomical and functional outcomes. Semin Ophthalmol. 2011;26(2):42-6.
16) Kwon S II, Ko SJ, Park IW. The clinical course of the idiopathic epiretinal membrane after surgery. Korean J Ophthalmol. 2009; 23(4): 249-252.
17) Mori K, Gehlbach PL, Sano A, Deguchi T, Yoneya S. Comparison of epiretinal membranes of differing pathogenesis using optical coherence tomography. Retina. 2004;24(1):57-62.
18) Wilkins JR, Puliafito CA, Hee MR, Duker JS, Reichel E, Coker JG, Schuman JS, Swanson EA, Fujimoto JG. Characterization of epiretinal membranes using optical coherence tomography. Ophthalmology. 1996;103(12):2142-51.
19) de Bustros S, Thompson JT, Michels RG, Rice TA, Glaser BM. Vitrectomy for idiopathic epiretinal membranes causing macular pucker. Br J Ophthalmol. 1988;72(9):692-695.